Breast checks don't help

Regular self-checking does not help cut the number of deaths from breast cancer, a major study reveals.

Researchers found little evidence that the practice leads to earlier detection of the disease.

"In spite of the fact that we spend all of this time and effort in teaching breast self-exam, the women were not able to detect lumps early enough to make a difference," said Dr David Thomas, author of the study.

The findings, published today at the start of Breast Cancer Awareness Month, underline advice first given to British women 10 years ago.

They were asked to become "breast aware" and report changes in shape, rather than ritually check themselves each month. Dr Thomas and colleagues at the Fred Hutchinson Cancer Research Centre in Seattle carried out the extensive study, which appears today in the American Journal of the National Cancer Institute, in an effort to settle the issue.

Researchers randomly assigned half of 266,000 women factory workers in Shanghai to one of two groups. Women in one group were all trained to perform the examinations properly.

They received monthly reminders, then conducted the examinations under medical supervision every six months for five years.

The second group of women received no information on breast cancer screening. Dr Thomas said that after more than a decade, the researchers found almost no difference between the two groups in the rate of death from breast cancer.

Among those in the instruction group, 135 women died from breast cancer. Among women in the other group, 131 did.

Dr Thomas said the study did not mean that women should stop breast self-examination, but that they should not have unrealistic expectations about its value. "Unless a woman is highly self-motivated, I wouldn't push it on her because it may be a waste of time," he said.

In Britain, policy changed in 1991 after the government's chief medical officer

confirmed that breast self-examination had no impact on breast cancer mortality.

And a study by the NHS breast screening programme revealed that although more than 80 per cent of women knew about self-examination, only three per cent did it - and many felt guilty about not doing it properly.